See our latest research paper here.
This information on BPRS is provided as a guide to our research on an evidence-based approach to pain management and our use of robust processes for quality assurance of our program.
The interdisciplinary service provides a fortnight-long residential program of medical, physical and psychological interventions. Outcome measures for each patient are compared to their intake scores, which are then used to guide the recommendations made to referrers at the end of the program. The outcomes are also provided to patients. We currently maintain a research data base of approximately 500 de-identified patients who have attended the program over the past 10 years that we use for ongoing research in the naturalistic setting of a community based practice.
In 2011 we published a pilot study in the journal Clinical Psychologist on the outcomes of the program (1). Based on 129 patients, we measured six psychological components of the chronic pain syndrome (depression, anxiety, stress, pain catastrophising, kinesiophobia and pain acceptance), both on entry to the program and on discharge two weeks later. We reported a significant group improvement in response to the program in all symptoms measured. The extent of symptom improvement ranged from 9% to 42% depending on the symptom. The proportion of participants who showed reliable improvements on their own baselines (calculated using the Reliable Change Index) ranged from 22% to 50% depending on the individual symptoms measured. Thus, our results confirmed the overall group effectiveness of the pain management program, but also highlighted the need to identify predictors of individual responsiveness based on patient characteristics.
In 2017, we published our findings on predictors of responsivity to interdisciplinary pain management in the journal Pain Medicine, which is a leading international journal (2). We found that physical, psychological, and social outcomes all improved in a significant proportion of participants. High baseline depression was a clinically reliable predictor of individual-level improvement. Individuals with nociceptive pain and those who were older showed the largest response across multiple outcomes and domains.
We have used our research findings to guide us in refining our measures to be more valid, sensitive and reliable, and have commenced these new measures. We have also modified the psychology component of the program to incorporate Mindful Cognitive Behavioural Therapy (MCBT) based on Dr Melissa Day’s book, Day, M.A. (2017). Mindfulness-Based Cognitive Therapy for Chronic Pain: A Clinical Manual and Guide. Chichester, UK: Wiley. Our research is conducted with the oversight and approval of the University of Queensland Human Research Ethics Committee.
Peer Reviewed Publications
(1) Han, X., Geffen, S., Browning M., Kenardy J. and Geffen, G. Outcome evaluation of a multidisciplinary pain management programme comparing group with individual change. Clinical Psychologist 15 (2011) 133-138
(2)Day M., Brinums M., Craig N., Geffen L., Geffen S., Lovai M., & Geffen G. Predictors of Responsivity to Interdisciplinary Pain Management. Pain Medicine 0: 1-14, 2017
Investigator Initiated Research Grant (Pfizer Tracking Number WS1752197) 2012-2017 $186,000. Patient predictors of therapeutic responsiveness in a multidisciplinary pain management program.
Media and Presentations
Day, M.A., Geffen, G., Sullivan, M. The theoretical, empirical and clinical advances in persistent pain management. The 1st APS Congress, Melbourne, Victoria, September, 2016.
Day, M.A. Psychology in pain management and practitioner self-care. Australasian Faculty of Rehabilitation Medicine (AFRM) Annual Trainees Meeting, Gold Coast, Queensland, March 14, 2015.
Geffen, S., Day, M.A., Craig, N. Putting patients in control of their pain: Brisbane pain and rehabilitation service (BPRS). Pain and Palliative Care Conference, Brisbane, Queensland, December 3, 2014.
Day, M., Brinums, M., Craig, N., Geffen, S., & Geffen, G. (2016). Reversing maladaptive plasticity in chronic pain. InPsych, 38(4), 18.